A Glimpse of Real Life
Wednesday, April 13, 2011 |
posted by Lori Power |
It is an all too common scenario for those of us in the benefits world to hear of employees who chose not to participate in the benefit plan only to need it later.
While an employee may have health and dental coverage through their spouse's plan, that spousal plan does not cover the employee for life or disability coverage. If the employee refuses all benefits, they and their family have no coverage for the employee in the event of an accident or illness that disables them or takes their life.
Maybe it’s a year or two, or maybe it’s as soon as three months later and this employee suffers a stroke, is in a car accident or is hurt while working on a truck. Now they have no benefits to help them through this difficult time.
Once treatment is received, the first phone call typically goes to the employer to check what benefit plan they are on and if they have disability coverage. For those without coverage, that call frequently goes like this:
“I know I turned it down before, but now I need the coverage and I’m willing to pay the premiums. It’s pretty tight just now with no income and all of my existing insurance is tied to my house, car and other loans … I thought I had coverage, but I’ve just gone through everything and I don’t. When I was offered the plan, I didn't realize I wasn't covered for this and now I have a family that needs to eat, be clothed and bills to be paid and I have no income.”
Don't be the one to make this phone call. Insurance carriers cannot make exceptions in this type of situation. Just like with car insurance, you cannot get coverage once you are sitting in the middle of the intersection involved in a car accident. There is NO coverage available after an incident has occurred.
Was your coverage clearly explained to you? Do you know what coverage you and/or your spouse have? Have you ever experienced a situation like this?
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